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Surgical Masks: A Tale of Two Paradigms
We are hearing more discussion about encouraging mask-wearing in the US. What is changing? According to this article and what I’m hearing from my hospital, it’s actually a shift in paradigm.
A face mask will not protect you from being exposed to COVID-19. It will generally cover your nose/mouth and prevent accidentally touching them, but it is not protective from the virus itself. That requires a particulate respirator, like an N95.* However, particulate respirators can be dangerous for people with poor breathing conditions. We saw how our garbage media have run with the fish tank anti-parasite chemical story. All it would take is one lady stuffing an N95 on her asthmatic husband, and media would be portraying Trump as personally choking the guy to death like Darth Vader. Also, people need to shave to use a normal respirator. The media would tun that into Trump wanting to kill orthodox rabbis and Muslim men.
Realistically, we apply PPE as the last resort in controlling a hazard, and only have people who need the PPE wear it. Right now, people are working out how to reuse disposable N95 masks, in addition to using one mask for the whole shift. The people with the highest risk in hospitals and clinics need the N95s desperately. In a war, it is challenging enough to get ammo for all of the soldiers on the front line, without getting everyone at home a full stock of ammo as well. That’s why you have not heard about masks – the ones available in mass quantities or craftable at home are do not protect the individual, while the N95s need to be kept for front-line people.
So why are they reconsidering masks for everyone? Because the masks protect other people from you. In essence, this approach looks at all people as potential carriers of the virus. A mask thick enough to stop droplets can be made at home without too much trouble, and there is no problem with reusing the mask as the only germs it has on it are ones you already have. This community-focused paradigm is more common in Asia, and I expect it to be a harder sell over here. Think of it as a portable quarantine.
The reason I call this a paradigm shift is that the facts I mentioned above have not changed. The change was in how we view and interpret them. When I saw the announcement from Infection Control that mentioned replacing self-quarantine with masks for people without symptoms, you could imagine a light-bulb popping up over my head.
So, Wear a Mask, Protect America … from yourself.
* Respirator classification notes: The letter determines how the respirator handles oil. No oil, oil-Resistant, or oil-Proof. The number refers to the mask’s efficiency at capturing particles. 95%, 99%, or 99.97%. P100 is normally sold as cartridges for a reusable respirator, like for asbestos/lead paint removal.
Published in Healthcare
It is also a barrier from touching your face, which is the most important thing you can do.
If everyone wears a mask we can cut transmission of respiratory disease by up to 80%
“The superiority of N95 respirators over medical masks could reflect the ability of N95 respirators to protect users from infectious aerosols or indicate higher effectiveness against droplet contagion. Nonetheless, our meta-analysis revealed that use of both N95 respirators and medical masks was associated with up to 80% reduction in risk of SARS.”
First large droplets will get trapped. Second even is you are exposed to some aerosol, it will stop some of it. We believe that the size of the initial inoculum in the infection is important. If you get a large bolus of virus particles it can overwhelm your body before your immune system can ramp up. Smaller inoculum, more time for the body to adapt before being overwhelmed.
Ignore the propaganda. If you have a mask wear it.
I’ve been speculating that widespread use of masks, coupled with a more reserved culture in general, might be the reason that Oriental nations like South Korea and Japan have not suffered a serious outbreak. I have no empirical evidence of this, just a suspicion.
Where is the evidence that ordinary masks will not provide protection? Do they provide no protection whatsoever, or are they merely less effective than the N95?
I was also thinking of posting on the linked article because I thought the purpose of masking was precisely that – to prevent the wearer from spreading “whatever” from the nose and mouth. I understood the desire to keep the protective (PPE) type masks prioritized, and while I don’t appreciate being lied to (“they don’t do any good”), given the toilet paper hoarding there surely would have been a run on the N-95 bank.
The surgical type masks, however, are the type now being mass produced and during a pandemic type situation it may become a societal expectation that everyone wear these when out and about. If it became a later expectation that we wear then when we have head colds, etc. – that might actually be a good change. Having said that, however, some of the “experts” say we should not be wearing masks because that will cause us to touch our face more, or, that we’ll imagine ourselves less vulnerable and not honor the social distance rules. Despite the couple that drank aquarium cleaner I think most people can understand the purpose of this type of masking and that this could be a good step for the effort.
Having said all of the above, I am not presently masking myself because (1) I don’t have a mask (other than shop masks with big filters on them), and (2) I’m a bit concerned that if I venture out with a mask on people will assume I am ill (I’m not, so far as I know) and may be annoyed with me for being out and about, (3) I’m just not the trend setter type, and (4) I’m stunningly handsome and wouldn’t want to detract from my appearance which brings much pleasure to people during these bleak times.
I’ve been wearing n95s to the grocery store. I figure it can’t hurt. The seal isn’t perfect, especially around the nose, but I’m going to start wrapping a bandana around the mask, as well as wearing protective goggles.
I got a bunch of this gear a few years back to wear when I went into the crawl space of my house. Then forgot about it until a few weeks ago. I gave a bunch of masks to a friend whose sister and brother and law are a nurse and doctor. They had none to wear. I will reuse the masks I have by putting each in an unzipped ziploc bag for a week or more before using it again. During which time, if I understand correctly, any virus on the mask will not be able to survive.
It’s about the particle size. They can stop a droplet, but not the much, much smaller virus. N95 respirators are much better at filtration, and thus that’s what you want to wear if you are caring for someone with active COVID-19.
Make sure you are clean-shaven, the elastic is tight, and it fit closely on your nose. Don’t do this if you have breathing trouble – they can be like breathing though a sock. I actually wore a bandana outside yesterday – I’d imagine it would work at least as well as a surgical mask.
Not sure on the 1 week in a bag approach. I believe they need to exposed to dry air for a week to kill the virus. This is an active area of research right now – people are looking into multiple forms of sterilization, and trying to see if they would leave the mask still usable.
I understand this, but it does not answer the question. It is my understanding that the virus is contained in respiratory droplets in the air, and that the virus is not technically “airborne” (meaning transmitted by droplet nuclei smaller than 5 microns). This is according to a WHO study just released on March 29 (here).
I have no idea who is correct here (no pun intended). Your statement is that an ordinary mask will stop a droplet, and WHO says that the transmission is by droplets (and contact). Which implies, I think, that ordinary masks should work.
Actual empirical evidence on effectiveness would be helpful.
I’ve read you can put them in a 150 degree oven for 30 minutes, but not letting it touch any metal surface.
Here’s an easy no-sew mask. It’s purpose is mostly to keep asymptomatic people from inadvertently coughing the virus onto surfaces. If we all wore masks, it would help enormously. The fewer virus-laden droplets around us, the lower the chances of others being infected. The lower the number of infected people around us, the lower the chances of our being infected. :-)
Yes. Any mask decreases at least a little bit your odds of getting sick from being coughed on. Them things probably stop infections that way daily in every metro system in east Asia.
There is nothing new under the sun.
South Korea. Hong Kong. Singapore.
It’s not perfect, but it helps.
Actual high-quality empirical evidence from a rigorous experiment would be more helpful, of course.
That could be due to the communal protection effect that was the subject of my post, and @marcin mentioned above.
I highly recommend wearing a mask, and I will be wearing a mask / face when going outside. Even if the mask is not protective for me, it protects other people if I a am carrier.
We know that aerosol transmission occurs. It’s no longer in doubt.
Again,
The CDC recommends storing a N95 for reuse in a clean paper bag. Since that’s the only ready-made mask about our house (I already had a habit of having a few around to re-use for shop projects), that’s the mask we’ve been using, even though it’s overkill for the purpose of protecting others from ourselves, and underkill if our goal were ensuring we were wearing it properly to fully protect ourselves from others.
Storing a N95 in paper for re-use does seem to beat my old practice of leaving it out till I thought it was dry, then putting it in a plastic baggie.
So why are they reconsidering masks for everyone? Because the masks protect other people from you. In essence, this approach looks at all people as potential carriers of the virus.
I wore masks every day for 50 years to protect patients I was operating on. I think there is a bit of hysteria but I was in the “senior citizen” line at Costco Thursday and saw about 12 masks among a thousand people in line. Several stores, and Costco, now have plexiglas screens at the counter, which I think it a good idea. I live in Tucson, which is hot, dry and lots of air. If I were so unfortunate as to live in NYC I would wear a mask going out.
And the CDC just turned on a dime….
Update (1740ET): As expected, President Trump said Friday that the CDC has reversed its position on face masks – it had previously recommended that Americans specifically not buy masks to alleviate supply shortages creating problems for hospitals and doctors offices – and is now officially recommending that all Americans wear masks when they venture out in public.
Effects of Ultraviolet Germicidal Irradiation (UVGI) on N95 Respirator Filtration Performance and Structural Integrity
I built a UVc light box at home for just such a purpose.
You can also heat them in the oven at 160 deg for 30 minutes. Put them on a wooden, glass or silicone surface to keep them from contacting metal in the oven.
You can apply a thin layer of vaseline to the inside edge of your mask to get a better seal if needed.
How long before those of us who choose not to wear one are berated and beaten for our non-compliance?
Naw. Just shunned.
A normal day for me.
If we stipulate that there is some benefit (personal, societal, whatever) to a healthy person wearing some type of mask (bandana, surgical, repurposed t-shirt, whatever), then should I be wearing my 3M Dust Mask when I am out and about?
I am asking sincerely. It’s so hard to get good information.
Yes, there is some benefit even to having a scarf over your face.
Wear the best mask you have, unless you’re conserving the best one for a rainy day or giving it to someone in greater need.
The benefits include:
–reducing odds of droplet-based infection from others to you,
–reducing odds of the reverse if you should happen to be a sympomless carrier,
–and cutting back on dust and allergens so you’re healthier and better able to fight the coronavirus if you should get it.
(I hate that gross medical word. “Droplet”–shudder!)
Why don’t we wear masks all the time? Because there’s a cost to doing so. We don’t do everything that might maybe possibly in some remote chance do some good in one area without considering the costs and risks associated with doing those things.
I still don’t see enough risk of transmission in my small sparsely populated town nor enough severity of illness to most people to justify yet more discomfort and cost.
At some point every town will get the virus. But if you’re not in a lot of close quarters with people, maybe the cost-benefit turns out differently in your case.
That makes sense. In Boston yesterday, on the deserted streets of the Back Bay only I was masked. Ditto at Mass Pike rest stops. Today in staples and the Grocery and the Pharmacy, about ten % of people were masked.
In a populous place, right now you’re a darned fool, and an irresponsible one, to be unmasked in public.
I remain one of those who think that the public is overreacting to the risks. The public, acting in response to the media, is behaving as though every single person who comes into any contact with the virus definitely dies a horrible death.
Destroying the economy, quite possibly, yes.
What I like about masks is it
helps stopslows transmission of the virus but lets people keep working.Hong Kong, Singapore, South Korea.